crossing96/oncoscreening huggingface dataset:
Global burden and inequalities of bladder cancer attributable to high fasting plasma glucose: Trends 1990-2021 and Projections to 2040.	Bladder cancer (BC) is a major global health issue, with higher incidence in males and significant regional disparities. High fasting plasma glucose (HFPG), a key metabolic risk factor, is linked to BC, but its global burden and future trends remain underexplored. We calculated the number of BC deaths, disability-adjusted life years (DALYs), age-standardized mortality rates (ASMR), and age-standardized DALY rates (ASDR) related to HFPG using data from the Global Burden of Disease 2021 database. Temporal trends were assessed using estimated annual percentage change, and inequalities were analyzed using a socio-demographic index. The Bayesian age-period-cohort model projected future burden to 2040. All analyses included 95% uncertainty intervals. In 2021, HFPG accounted for 7.9% of global BC deaths and 7.4% of DALYs. From 1990 to 2021, HFPG-related BC deaths increased by 288.3%, and DALYs increased by 263.4%. Males and older populations bore a higher burden, with ASMR and ASDR showing moderate global increases (estimated annual percentage change: 0.65 for ASMR; 0.48 for ASDR). High-income regions, particularly North America and Central Europe, had the highest ASMR and ASDR. Projections indicate a significant decline in HFPG-related BC burden by 2040, especially among males. The global burden of BC attributable to HFPG has risen significantly, with high-income regions and older males most affected. Despite projected declines by 2040, targeted prevention strategies, including lifestyle interventions and improved metabolic risk factor management, are essential to reduce future burdens and address disparities globally.	bladder
The worldwide adoption of enhanced endoscopic imaging in diagnosis and treatment of non-muscle invasive bladder cancer (NMIBC): snapshot analysis from a global survey.	PURPOSE: To describe the availability and use of enhanced endoscopic imaging technology as well as the factors that impact endoscopic imaging method preferences in the treatment of NMIBC. METHODS: A cross-sectional online survey was prepared to capture real-life practices globally, in the endoscopic assessment and treatment of NMIBC. The survey was distributed by the Société Internationale d'Urologie (SIU) to all its members and made available in 7 languages. The data was reported quantitatively, measuring variability and central tendency. RESULTS: From the 3595 respondents (across 91 countries) 39.1% were in practice for > 20 years and 56,5% were general urologists, followed by 16.8% uro-oncologist and 8.4% endourologist. White light (WL) was the most often available endoscopic technology. Of the respondents, 60% perform < 5 TURBT/month and only 15% perform > 10 TURBT/month. 64% of the respondents had only access to WL endoscopy whereas 29% of the respondents had access to NBI, 11% to PDD and 6% to IMAGE 1S. The majority agreed on their benefit in tumor resection, detection of satellite lesions and decrease recurrence rate in pT1 tumors. Lastly, half of the respondents reported not having followed any training on the use of enhanced techniques. CONCLUSION: Overall, there is the belief that the use of enhanced imaging techniques allows for a more complete TURBT and to prevent recurrences. Notably most respondents performed less than 5 TURBTs/month, and the highest volume is performed by general urologists. Respondents predominantly have access to WL endoscopy only, mostly due to income, work setting, and lack of training.	bladder
Impact of the CALLY Index in Predicting Overall Survival and Disease-Free Survival in Patients Undergoing Radical Cystectomy for Muscle-Invasive Bladder Cancer.	BACKGROUND: Muscle-invasive bladder cancer (MIBC) is associated with poor survival outcomes despite radical cystectomy (RC), creating a clinical need for simple and reliable prognostic biomarkers. AIM: The CALLY index, a composite biomarker derived from serum C-reactive protein (CRP), albumin, and lymphocyte counts, reflects systemic inflammation, nutritional status, and immune function. Its prognostic utility in MIBC has not been fully elucidated. To evaluate the prognostic value of the CALLY index in predicting overall survival (OS) and disease-free survival (DFS) in patients undergoing RC for non-metastatic MIBC. METHODS: In this retrospective cohort study, 134 patients who underwent RC for non-metastatic MIBC between February 2014 and January 2024 were included. Patients who received neoadjuvant chemotherapy, had secondary malignancies, or active infections were excluded. The CALLY index was calculated as follows: (Albumin [g/dL] × Lymphocyte count [10⁹/L])/CRP [mg/dL] ×10⁴. Kaplan-Meier and receiver operating characteristic curve analyses were used to evaluate survival outcomes and the predictive performance of the index. RESULTS: Patients with a CALLY index of ≥1.33 had significantly longer OS (median 62 vs. 29 months, p < 0.001), and a cut-off of ≥1.11 was predictive of improved DFS (p = 0.004). The index demonstrated moderate discriminative ability (AUC: 0.682 for OS; 0.647 for DFS). CRP and albumin were independent prognostic factors, whereas lymphocyte count was not. CONCLUSION: The CALLY index may serve as a valuable prognostic tool in patients with non-metastatic MIBC undergoing RC. Its incorporation into clinical risk stratification models could enhance individualized treatment planning. Prospective studies are warranted to validate these findings.	bladder
MAP30 inhibits proliferation and metastasis of bladder cancer by increasing EGR1 expression and promoting the transcriptional activation of DUSP1.	The confirmed tumor-inhibitory effects of the 30 kDa Momordica anti-human immunodeficiency virus protein (MAP30) have yet to be complemented by an exploration into its mechanism of action on tumor development and metastasis. For this purpose, we delved into the intrinsic mechanism of MAP30 in bladder cancer (BC). Here, we demonstrated that MAP30 markedly suppressed the proliferation, migration, invasion, and angiogenic capabilities of human BC cells in vitro, and the tumor metastatic potential in vivo. Furthermore, our findings showed that MAP30 suppressed the functional activities of BC cells by upregulating the expression levels of early growth response 1 (EGR1). Additionally, our investigation confirmed that EGR1 and dual specificity phosphatase 1 (DUSP1) were down-expressed in BC and had been identified as closely linked to the advancement of BC. DUSP1 was transcriptionally induced by EGR1, and the expression of EGR1 was found to be positively linked with DUSP1 in human BC tissues. The knockdown of EGR1 was found to boost cell invasion, migration, proliferation, and angiogenesis via the MAPK signaling pathway, however, the overexpression of DUSP1 inhibited EGR1 knockdown-induced promotion of these functional activities in BC cells. Furthermore, MAP30 inhibited the invasion, migration, proliferation, and angiogenesis of BC cells by regulating the EGR1-DUSP1 axis. Our study yielded an exhaustive insight into the suppressive actions of MAP30 on BC progression.	bladder
Association between long-term exposure to a mixture of ambient air pollutants and the incidences of bladder and kidney cancers.	BACKGROUND: Evidence regarding associations between air pollution and urinary system cancers, including bladder cancer (BC) and kidney cancer (KC), remains limited and inconsistent. This study assessed the impact of long-term exposure to air pollutant mixtures on BC and KC incidence. MATERIALS AND METHODS: Using data from the Korean National Health Information Database (2011-2021) and air pollution estimates (2007-2019), we conducted a nested case-control study involving 3788 BC cases with 15,152 matched controls and 4084 KC cases with 16,336 matched controls. Long-term exposure to PM(10), PM(2.5), NO(2), SO(2), and CO was estimated as 5- and 10-year averages with 1- or 2-year lag periods before cancer diagnosis. Quantile g-computation models were used to evaluate mixture effects, adjusting for age, sex, BMI, smoking status, alcohol consumption, and socioeconomic status. RESULTS: Exposure to air pollutant mixtures was significantly associated with increased BC risk across all exposure scenarios, with odds ratios (ORs) ranging from 1.58 to 1.70 (all p < 0.05). For KC, significant associations were also consistently observed, with ORs ranging from 1.17 to 1.23 (all p < 0.05). PM(10), PM(2).(5), and SO(2) consistently demonstrated positive contributions to both cancers, whereas NO(2) and CO showed inverse associations across all exposure conditions. CONCLUSION: Long-term exposure to mixtures of air pollutants was significantly associated with increased risks of BC and KC, with consistent positive contributions identified for PM(10), PM(2.5), and SO(2). These findings highlight specific pollutants of concern and emphasize the need for targeted public health strategies to mitigate air pollution exposure and potentially reduce urinary cancer incidence.	bladder
The association between prior pelvic radiotherapy for cancer and surgical outcomes in patients undergoing radical cystectomy for bladder cancer: An analysis of national surgical quality improvement program targeted cystectomy database.	INTRODUCTION: Patients undergoing radical cystectomy (RC) for bladder cancer (BCa) may have previously received pelvic radiotherapy (pRT), which is both a risk factor for BCa and is independently associated with an increased risk of intraoperative and postoperative complications. We sought to quantify this risk at the population level and to assess rates of granular, cystectomy-specific and general surgical outcomes of patients undergoing RC who received pRT for any pelvic malignancy any time prior using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) Targeted Cystectomy database. METHODS: We conducted a retrospective cohort study using the ACS-NSQIP targeted cystectomy dataset of patients 18-90 years old who underwent RC for BCa from 2019 to 2022. The primary outcomes included rates of cystectomy-specific outcomes potentially related to pRT (e.g., rectal injury) and 30-day major postoperative outcomes: mortality, reoperation, cardiovascular events, and readmission rates. Secondary outcomes included general surgical complications such as rates of sepsis, surgical-site infections (SSIs), length of hospital stay (LOS) and surgery duration. We balanced for potential confounders by propensity score matching (PSM) with a 1:5 ratio between pRT and no-pRT groups with a caliper of 0.009. RESULTS: We identified 5,058 patients of whom 403 (7.97%) had pRT prior to RC. After PSM, the analytical cohort consisted of 1,901 RC patients and 387 RC + pRT patients. Prior pRT was associated with significantly higher odds of rectal injury (OR 3.17, 95% CI: 1.59-6.33). Additionally, prior pRT was associated with infectious complications, including SSI (OR 1.48, 95% CI: 1.08-2.39), organ-site infection (OR 1.61, 95% CI: 1.08-2.39). Subgroup analyses suggested the association between prior pRT, and rectal injury was statistically significant among patients with age ≥ 65 years, BMI 25-29.9, open approach for RC and norreceipt of neoadjuvant chemotherapy. CONCLUSIONS: In a contemporary real-world, multicenter cohort, patients undergoing RC after pRT were associated with 3-fold higher odds of rectal injury, and higher odds of multiple infectious complications. These data provide a framework to assist in patient counseling and optimizing selection.	bladder
A Clinically Practical Nomogram for Predicting Survival in Elderly Patients (≥ 65 Years) With Bladder Urothelial Carcinoma: A Study Based on SEER Database and External Validation.	BACKGROUND: Bladder urothelial carcinoma is a common malignancy in the elderly, yet accurate prognostic tools for older patients remain limited. AIMS: This research aimed to create and validate nomogram predicting overall survival (OS) for elderly patients aged 65 years and older with urothelial carcinoma of the bladder (UCB). METHODS: We sourced 12702 UCB patients diagnosed between 2004 and 2015 from the Surveillance, Epidemiology, and End Results database. The patients were randomized into training (70%) and internal validation (30%) cohorts. In addition, 55 patients from Minzu Hospital of Guangxi Zhuang Autonomous Region between 2012 and 2022 were selected as the external validation cohort. Utilizing univariate and multivariate Cox regression analyses, we devised a nomogram forecasting 1-, 3-, and 5-year OS. Several metrics, including the consistency index (C-index), calibration plots, area under the receiver operator characteristics (ROC) curve, and decision curve analysis (DCA) were used to validate the validity and clinical utility of the nomogram. Patients were categorized into high- and low-risk profiles, and their survival outcomes were contrasted using the Kaplan-Meier method and the log-rank test. RESULTS: Age, race, marriage, AJCC stage, tumor size, surgery, radiotherapy, and chemotherapy were identified as independent prognostic factors of OS. In the training cohort, internal validation cohort and external validation cohort, the nomogram for predicting OS achieved C-index values of 0.673 (95% CI: 0.665-0.681), 0.672 (95% CI: 0.660-0.684), and 0.826 (95% CI: 0.732-0.920), respectively. In all cohorts, the calibration plots revealed high consistency between actual and predicted values. The nomogram depicted by ROC and DCA showcased superior stability, predictive value, and clinical applicability for 1, 3-, and 5-year OS. The risk stratification delineated patients into low- and high-risk brackets, revealing significant prognostic distinctions (p ⟨ 0.05). CONCLUSIONS: Based on the SEER database and Chinese data, we developed a reliable nomogram forecasting 1-, 3-, and 5-year OS for older patients with UCB. The nomogram can identified high-risk and low-risk patients, aiding clinicians in personalised treatment and prognostic evaluations. This allows high-risk patients to receive intensive treatment or close follow-up, while low-risk patients can avoid overtreatment.	bladder
The Emerging Role of B Cells and Tertiary Lymphoid Structures in Bladder Cancer.	"PURPOSE OF REVIEW: To provide a comprehensive review of new and emerging literature on B cells and tertiary lymphoid structures (TLS) in urothelial cancer. RECENT FINDINGS: The presence of certain subsets of B cells and TLS in MIBC are associated with improved outcomes and response to immunotherapy. However, the role in NMIBC is less clear. TLS in NMIBC is likely associated with more aggressive disease but may also be associated with improved outcomes to intravesical BCG. This review outlines an emerging potential biomarker (TLS) for predictive and prognostic outcomes for patients with urothelial cancer receiving either intravesical BCG or systemic immunotherapy. B cells play a complex role in the tumor immune microenvironment and can be either anti- or pro-tumor. Activated B cells form TLS which lead to a robust response to immunotherapy. This has led some investigators to attempt therapeutic manipulation to induce TLS in otherwise immunologically ""cold"" tumors."	bladder
UK multidisciplinary recommendations on use of combination first-line enfortumab vedotin▼ and pembrolizumab in advanced urothelial carcinoma.	BACKGROUND: Advanced urothelial carcinoma (UC) significantly impacts quality of life, is associated with poor prognosis, and carries a high economic burden. Recently, the combination of enfortumab vedotin and pembrolizumab (EV-P) has demonstrated improved progression-free survival vs platinum-based chemotherapy and overall survival, and is now recommended as a first-line therapy for patients with unresectable or metastatic disease who are platinum eligible. METHODS: A multidisciplinary expert panel was convened to review the current UK patient pathway for advanced UC. The panel developed consensus recommendations for implementing EV-P in the United Kingdom and provided guidance on managing adverse events (AEs), taking into account the challenges in the current pathway. RESULTS: The expert panel recommended leveraging lessons from the previous implementation of new immunotherapies and antibody-drug conjugates as EV-P is implemented across the United Kingdom. They emphasized the importance of peer support from clinical centers involved in the EV-302 phase 3 clinical trial, advocating for the sharing of protocols, advice, and support for toxicity management. Recommendations included establishing robust referral pathways and multidisciplinary care models tailored to the resources and structures of different hospital settings. Education in proactive side effect identification and management was recommended for bladder cancer clinical nurse specialists, acute oncology nurses, pharmacists, and clinicians. The panel developed patient checklists to support clinicians in assessing treatment suitability, monitoring AEs during therapy, and ensuring continued monitoring after treatment ends. Detailed recommendations were provided for managing AEs, with a focus on skin reactions, peripheral neuropathy, hyperglycemia, pneumonitis/interstitial lung disease, and ocular disorders, along with guidance on when to involve specialist services. CONCLUSION: These consensus recommendations provide practical, multidisciplinary guidance to support the effective implementation of EV-P for advanced UC in UK healthcare settings.	bladder
Serum xanthine oxidoreductase and oxidative stress are associated with bladder cancer: a case-control study from Jordan.	Xanthine oxidoreductase (XOR) is an oxidant enzyme that exists mainly in two distinct forms: the dehydrogenase form [xanthine dehydrogenase (XDH)] and the oxidized form [xanthine oxidase (XO)]. XO might contribute to tumorigenesis through direct metabolic activation of carcinogens and indirect generation of free radicals. Oxidative stress is one of the leading causes of bladder cancer (BC). Smoking and genetic susceptibility are also linked to oxidative stress and BC. This study investigated the association between XO serum levels and XOR genetic polymorphisms with BC. A case-control study was conducted among 109 BC patients and 109 controls matched by age, gender, body mass index, and smoking status. Serum levels of XO and 8-hydroxy-2'-deoxyguanosine (8-OhdG) were measured using ELISA, while thiobarbituric acid reactive substances (TBARS) and protein carbonyl (PC) were assessed using colorimetric assays. XOR single nucleotide polymorphisms were analyzed via tetra-primer ARMS-PCR. XO levels were significantly higher in BC patients than in controls [(5.11 ± 0.28 vs 3.83 ± 0.23) ng/ml, respectively (p < 0.0006)]. Among smokers, XO levels were also elevated in BC cases compared with controls [(5.29 ± 0.35 vs 3.41 ± 0.28) ng/ml, respectively (p < 0.0001)]. Oxidative stress biomarkers were elevated in BC patients compared with controls: 8-OHdG (19.39 ± 1.37 vs 16.32 ± 1.37 nmol/l), PC (8.88 ± 0.56 vs 4.42 ± 0.56) nmol/mg of protein, and TBARS (4.23 vs 3.15) µmol/ml, respectively (p < 0.05). Haplotype analysis showed that TGTCA, TGTA, TGA, and GTA were more frequent in BC patients and associated with increased BC status [4.17 (1.16-15.00), 1.84 (1.11-3.05), 1.62 (1.01-2.60), and 1.66 (1.02-2.71) fold increase in risk, respectively (p < 0.05)]. Elevated XO and oxidative stress markers are associated with BC, supporting their role in BC pathogenesis. Our findings suggest that they may act as potential diagnostic or therapeutic targets. However, mechanistic studies are required to clarify whether XO/oxidative stress markers contribute directly to carcinogenesis or reflects general redox imbalance in malignancy. Specific XOR haplotypes might serve as biomarkers for BC.	bladder
Natural killer cell-related gene signature predicts immune cell infiltration and improved survival in bladder cancer.	BACKGROUND: Natural killer (NK) cell-based therapies represent a promising immunotherapeutic approach for cancer treatment. This study aims to identify and evaluate the prognostic significance of NK cell-related genes in bladder cancer (BC). METHODS: Using RNA-seq data from The Cancer Genome Atlas (TCGA) BLCA cohort, an NK cell-related gene signature was constructed and validated via multivariate Cox regression. Functional enrichment analyses (GO and KEGG) were conducted to explore associated biological processes. Immune infiltration states were assessed using ESTIMATE and CIBERSORT algorithms. Immunohistochemistry (IHC) and multiplex immunofluorescence (mIF) were performed to validate key findings at the protein level. RESULTS: An eight-gene prognostic signature based on NK cell-related genes was established, enabling stratification of BC patients into high- and low-risk groups. Patients in the high-risk group exhibited significantly worse overall survival (OS) and progression-free survival (PFS). Multivariate analysis confirmed the signature's independence from other clinical variables. The signature was also correlated with distinct immune infiltration patterns, including CD8(+) T cells, CD4(+) activated memory T cells, follicular helper T cells, regulatory T cells, activated NK cells, activated dendritic cells, and M0/M2 macrophages. Notably, the key signature gene RAC3 was found to be highly expressed in a subset of tumors. This elevated RAC3 expression was associated with enhanced proliferation (increased Ki67) and reduced infiltration of CD8(+) T cells and CD56(+) NK cells, indicating an immunosuppressive microenvironment. Consistently, the TIDE score was significantly lower in the high-risk group, suggesting enhanced potential responsiveness to immunotherapy. CONCLUSION: The NK cell-related gene signature serves as a robust prognostic biomarker and predictor of immunotherapeutic efficacy in BC. These findings provide new insights into BC biology and facilitate personalized immunotherapy strategies.	bladder